Remote Mentoring of Point-of-Care Ultrasound Skills to Inexperienced Operators Using Multiple Telemedicine Platforms: Is a Cell Phone Good Enough?
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OBJECTIVES Telemedicine technology contributes to the teaching of point of care ultrasound US however expensive equipment can limit its deployment in resource challenged settings We assessed 3 low cost telemedicine solutions capable of supporting remote US training to determine feasibility acceptability and effectiveness We also explored the value of instructional videos immediately before telementoring METHODS Thirty six participants were randomly assigned to receive US mentoring in 1 of 3 telemedicine conditions multiple fixed cameras a smartphone and traditional audio with a live US stream Participants were then asked to perform a standardized US examination of the right upper quadrant under remote guidance We measured observer s global ratings of performance along with the mentor s and student s rating of effort and satisfaction to determine which of the 3 approaches was most feasible acceptable and effective During the second phase students were randomized to watch an instructional video or not before receiving remote coaching on how to complete a subxiphoid cardiac examination Effort satisfaction and performance from the independent observer s and student s perspective were surveyed RESULTS There was no significant difference between the different telemedicine setups from the observer s perspective however the mentor rated the smartphone significantly worse P 028 04 than other technologies Platforms were rated equivalent from the student s perspective No benefit was detected for watching an instructional video before the mentored task CONCLUSIONS Remote US skills can be taught equally effectively by using a variety of telemedicine technologies Smartphones represent a viable option for US training in resource challenged settings